Healthcare Provider Details

I. General information

NPI: 1952776544
Provider Name (Legal Business Name): PALM BEACH ELITE COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 12/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3385 BURNS RD SUITE 200
PALM BEACH GARDENS FL
33410-4328
US

IV. Provider business mailing address

3385 BURNS RD SUITE 200
PALM BEACH GARDENS FL
33410-4328
US

V. Phone/Fax

Practice location:
  • Phone: 561-324-2140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: SANDI BARNES
Title or Position: BOSS
Credential: CAP
Phone: 561-324-2140